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Trauma disparities

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https://www.readbyqxmd.com/read/27893241/ill-or-injured-shifting-the-emphasis-to-trauma-in-mental-health-diagnosis-and-treatment
#1
Matthew S Costanzo
TOPIC: This contribution examines the disparity that exists between research that identifies the prevalence of trauma among mental health service users and the low frequency of adequately diagnosing and treating trauma in practice. For this author, the important question to pose is "Could behavioral health services be persistently erring in both diagnoses and treatment approaches to adequately assist and support service users?" PURPOSE: The author proposes an alternative service model which is aligned with the prevalence of complex trauma...
December 2016: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/27869461/race-differences-in-depression-vulnerability-following-hurricane-katrina
#2
Jeanelle S Ali, Amy S Farrell, Adam C Alexander, David R Forde, Michelle Stockton, Kenneth D Ward
Objective: This study investigated whether racial disparities in depression were present after Hurricane Katrina. Method: Data were gathered from 932 New Orleans residents who were present when Hurricane Katrina struck, and who returned to New Orleans the following year. Multiple logistic regression models evaluated racial differences in screening positive for depression (a score ≥16 on the Center for Epidemiologic Studies Depression Scale), and explored whether differential vulnerability (prehurricane physical and mental health functioning and education level), differential exposure to hurricane-related stressors, and loss of social support moderated and/or reduced the association of race with depression...
November 21, 2016: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/27830939/burden-of-usa-hospital-charges-for-traumatic-brain-injury
#3
Jennifer R Marin, Matthew D Weaver, Rebekah C Mannix
OBJECTIVES: This study sought to estimate charges associated with USA hospital visits for traumatic brain injury (TBI), compare charges from 2006-2010 and evaluate factors associated with higher charges. METHODS: The Nationwide Emergency Department Sample database, 2006-2010, was used to estimate charges for emergency department visits and inpatient hospital stays associated with TBI and trends in charges over time were compared. Multivariable linear regression was used to evaluate factors associated with visit charges...
November 10, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27818408/piloting-specialized-mental-health-care-for-rural-women-veterans-using-stair-delivered-via-telehealth-implications-for-reducing-health-disparities
#4
Kathryn J Azevedo, Brandon J Weiss, Katie Webb, Julia Gimeno, Marylène Cloitre
This pilot project implemented a mental health program, STAIR, targeting basic skills in mood management training and social functioning for women veterans with military-related trauma who live in rural areas. We report on outreach and implementation procedures, the women veterans' reactions to the program, and lessons learned.
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27809859/variation-in-type-and-frequency-of-diagnostic-imaging-during-trauma-care-across-multiple-time-points-by-patient-insurance-type
#5
Nathaniel Bell, Laura Repáraz, William R Fry, R Stephen Smith, Alejandro Luis
BACKGROUND: Research has shown that uninsured patients receive fewer radiographic studies during trauma care, but less is known as to whether differences in care are present among other insurance groups or across different time points during hospitalization. Our objective was to examine the number of radiographic studies administered to a cohort of trauma patients over the entire hospital stay as well as during the first 24-hours of care. METHODS: Patient data were obtained from an American College of Surgeons (ACS) verified Level I Trauma Center between January 1, 2011 and December 31, 2012...
November 3, 2016: BMC Medical Imaging
https://www.readbyqxmd.com/read/27786496/racial-ethnic-differences-in-trauma-exposure-and-mental-health-disorders-in-adolescents
#6
Cristina M López, Arthur R Andrews, Andrea M Chisolm, Michael A de Arellano, Benjamin Saunders, Dean G Kilpatrick
Objective: Research has cited increased prevalence of mood disorders, anxiety disorders, and exposure to interpersonal violence for Hispanics and non-Hispanic Black adolescents, as well as ethnic differences in externalizing behavior (e.g., substance use, delinquency). The current study combined these areas by examining racial/ethnic differences in mental health correlates of trauma exposure. Method: Interviews were conducted to assess polyvictimization, posttraumatic stress disorder (PTSD), major depressive disorder (MDD), substance use, and delinquency in a nationally representative sample of adolescents (N = 3,614; 15...
October 27, 2016: Cultural Diversity & Ethnic Minority Psychology
https://www.readbyqxmd.com/read/27771038/demographic-and-socioeconomic-factors-influencing-disparities-in-prevalence-of-alcohol-related-injury-among-underserved-trauma-patients-in-a-safety-net-hospital
#7
Ikenna C Nweze, Jody C DiGiacomo, Silvia S Shin, Camilla Gupta, Rema Ramakrishnan, Lambros D G Angus
BACKGROUND: Alcohol-related trauma remains high among underserved patients despite ongoing preventive measures. Geographic variability in prevalence of alcohol-related injury has prompted reexamination of this burden across different regions. We sought to elucidate demographic and socioeconomic factors influencing the prevalence of alcohol-related trauma among underserved patients and determine alcohol effects on selected outcomes. METHODS: A retrospective analysis examined whether patients admitted to a suburban trauma center differed according to their blood alcohol concentration (BAC) on admission...
December 2016: Injury
https://www.readbyqxmd.com/read/27765646/relationship-of-childhood-adversity-and-neighborhood-violence-to-a-proinflammatory-phenotype-in-emerging-adult-african-american-men-an-epigenetic-link
#8
Linda Witek Janusek, Dina Tell, Noni Gaylord-Harden, Herbert L Mathews
African American men (AAM) who are exposed to trauma and adversity during their early life are at greater risk for poor health over their lifespan. Exposure to adversity during critical developmental windows may embed an epigenetic signature that alters expression of genes that regulate stress response systems, including those genes that regulate the inflammatory response to stress. Such an epigenetic signature may increase risk for diseases exacerbated by inflammation, and may contribute to health disparity...
October 17, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27760245/implications-of-the-patient-protection-and-affordable-care-act-on-insurance-coverage-and-rehabilitation-use-among-young-adult-trauma-patients
#9
Cheryl K Zogg, Fernando Payró Chew, John W Scott, Lindsey L Wolf, Thomas C Tsai, Peter Najjar, Olubode A Olufajo, Eric B Schneider, Elliott R Haut, Adil H Haider, Joseph K Canner
Importance: Trauma is the leading cause of death and disability among young adults, who are also among the most likely to be uninsured. Efforts to increase insurance coverage, including passage of the Patient Protection and Affordable Care Act (ACA), were intended to improve access to care and promote improvements in outcomes. However, despite reported gains in coverage, the ACA's success in promoting use of high-quality care and enacting changes in clinical end points remains unclear...
October 19, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27756739/defining-the-fracture-population-in-a-pragmatic-multicentre-randomised-controlled-trial-profher-and-the-neer-classification-of-proximal-humeral-fractures
#10
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27756238/world-wide-variation-in-incidence-of-acinetobacter-associated-ventilator-associated-pneumonia-a-meta-regression
#11
James C Hurley
BACKGROUND: Acinetobacter species such as Acinetobacter baumanii are of increasing concern in association with ventilator associated pneumonia (VAP). In the ICU, Acinetobacter infections are known to be subject to seasonal variation but the extent of geographic variation is unclear. The objective here is to define the extent and possible reasons for geographic variation for Acinetobacter associated VAP whether or not these isolates are reported as Acinetobacter baumanii. METHODS: A meta-regression model of VAP associated Acinetobacter incidence within the published literature was undertaken using random effects methods...
October 18, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27755396/tnf%C3%AE-variation-during-the-menstrual-cycle-and-thereafter-a-new-explanation-for-gender-based-disparities-in-icu-admission-rates-trauma-outcomes-and-general-mortality
#12
Katalin Gornicsar, Tibor Mózes, Andor Grosz, Edit Bíró, Szabolcs Ládi, Paul Clayton
BACKGROUND: Multiple studies have found gender-based disparities in ICU admission rates and in complications following trauma. Female gender was associated with lower mortality when comparing patients less than 50 years of age. These data suggest an important role for cycle rather than gender itself. Our previous results indicate a crucial role for tumor necrosis factor alpha (TNFα) in inducing nososocomial infections. HYPOTHESIS: Cycle is important for TNF and other female hormone productions...
October 12, 2016: Shock
https://www.readbyqxmd.com/read/27749765/trauma-induced-acute-x-chromosome-skewing-in-white-blood-cells-represents-an-immuno-modulatory-mechanism-unique-to-females-and-a-likely-contributor-to-sex-based-outcome-differences
#13
Geber Pena, Christina Michalski, Yong Qin, Robert Donnelly, Ziad Sifri, Anne Mosenthal, David Livingston, Zoltan Spolarics
Sex-related outcome disparities following severe trauma have been demonstrated in human and animal studies however sex hormone status could not fully account for the differences. This study tested whether X-linked cellular mosaicism, which is unique to females, could represent a genetically based mechanism contributing to sex-related immuno-modulation following trauma. Serial blood samples collected for routine laboratory tests were analyzed for ChrX inactivation (XCI) ratios in white blood cells. 39 severely injured (mean ISS 19) female trauma patients on mixed racial and ethnic background were tested for initial (baseline) and trauma-induced changes in XCI-ratios and their associations with severity of injury and clinical outcome...
September 29, 2016: Shock
https://www.readbyqxmd.com/read/27747757/urban-rural-disparities-in-oregon-pediatric-traumatic-brain-injury
#14
Megan J Leonhard, Dagan A Wright, Rongwei Fu, David P Lehrfeld, Kathleen F Carlson
BACKGROUND: Traumatic brain injury (TBI) greatly contributes to morbidity and mortality in the pediatric population. We examined potential urban/rural disparities in mortality amongst Oregon pediatric patients with TBI treated in trauma hospitals. METHODS: We conducted a retrospective study of children ages 0-19 using the Oregon Trauma Registry for years 2009-2012. Geographic location of injury was classified using the National Center for Health Statistics Urban/Rural Classification Scheme...
December 2015: Injury Epidemiology
https://www.readbyqxmd.com/read/27747749/race-and-rehabilitation-following-spinal-cord-injury-equality-of-access-for-american-indians-alaska-natives-compared-to-other-racial-groups
#15
Alan D Cook, Jeanette G Ward, Kristina M Chapple, Hassan Akinbiyi, Mark Garrett, Forrest O'Dell Moore
BACKGROUND: Representing 2 % of the general population, American Indians/Alaska Natives (AIs/ANs) were associated with 0.5 % (63) of the estimated 12,500 new cases of spinal cord injury (SCI) reported to the National Spinal Cord Injury Statistic Center in 2013. To date, the trend in health care disparities among AIs/ANs in the SCI community has not been examined. We sought to compare the rate of discharge to rehabilitation facilities (DRF) following traumatic SCI among adult AIs/ANs to other racial/ethnic groups for patients 15 to 64 years old...
December 2015: Injury Epidemiology
https://www.readbyqxmd.com/read/27745922/assessing-stress-related-treatment-needs-among-girls-at-risk-for-poor-functional-outcomes-the-impact-of-cumulative-adversity-criterion-traumas-and-non-criterion-events
#16
Amy E Lansing, Wendy Y Plante, Audrey N Beck
Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology...
October 6, 2016: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/27665279/racial-ethnic-disproportionality-in-psychiatric-diagnoses-and-treatment-in-a-sample-of-serious-juvenile-offenders
#17
Michael T Baglivio, Kevin T Wolff, Alex R Piquero, Mark A Greenwald, Nathan Epps
Psychiatric disorder prevalence has been shown demonstrably higher among justice-involved adolescents than youth in the general population. Yet, among arrested juveniles, little is known regarding racial/ethnic differences in disorder prevalence, the role of trauma exposure in the diagnosis of behavioral disorders, or subsequent psychiatric treatment provided to adolescents with such diagnoses. The current study examines racial/ethnic disparity in psychiatric diagnoses and treatment of behavioral disorders associated with delinquency, controlling for traumatic experiences, behavioral indicators, and prior offending among serious juvenile offenders...
September 24, 2016: Journal of Youth and Adolescence
https://www.readbyqxmd.com/read/27640909/outcomes-of-trauma-admission-for-falls-influence-of-race-and-age-on-inhospital-and-post-discharge-mortality
#18
Bethany L Strong, Jamila M Torain, Christina R Greene, Gordon S Smith
BACKGROUND: Racial disparities in trauma outcomes occur, but disparities in fall mortality are unknown. The objective of this study was to determine inhospital and 1-year fall mortality among patients discharged from an urban trauma center. METHODS: We conducted a retrospective analysis of fall patients in our trauma registry (1997 to 2008) linked to the National Death Index to determine postdischarge mortality. Statistical analysis included chi-square tests, multivariable logistic regression, and Cox proportional hazards models...
October 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27613720/low-trauma-fractures-and-bone-mineral-density-testing-in-adults-with-and-without-intellectual-and-developmental-disabilities-a-population-study
#19
R Balogh, J Wood, K Dobranowski, E Lin, A Wilton, S B Jaglal, M Gemmill, Y Lunsky
: Individuals with intellectual and developmental disabilities (IDD) are at risk for low-trauma fractures. We investigated the rate of low-trauma fractures and the odds of BMD testing in adults with/without IDD. Adults with IDD were more likely to have a low-trauma fracture, but there was no difference in bone mineral density (BMD) testing rates. INTRODUCTION: Individuals with IDD are at increased risk for developing osteoporosis which contributes to high rates of low-trauma fracture...
September 9, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27595109/hypotensive-resuscitation-among-trauma-patients
#20
REVIEW
Matthew M Carrick, Jan Leonard, Denetta S Slone, Charles W Mains, David Bar-Or
Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur...
2016: BioMed Research International
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